Department of Neurosciences, Mental Health and Sensory Organs-Suicide Prevention Center, Sapienza University of Rome, Sant'Andrea Hospital, 1035-1039 Via di Grottarossa, Rome 00189, Italy.
Eur Neuropsychopharmacol. 2013 Dec;23(12):1672-86. doi: 10.1016/j.euroneuro.2013.06.002. Epub 2013 Jul 27.
There is growing evidence that inflammatory mediators play a critical role in the pathophysiology of both major depression and suicidal behavior. Immunological differences have been reported in both major affective disorders and suicidal behavior. Specifically, increased levels of pro-inflammatory cytokines have been shown to correlate with the severity of depression and various cytokines have been identified as potentially important in understanding the pathophysiology of major affective disorders/suicidality. We aimed to conduct a systematic review of the current literature to investigate the association between inflammatory cytokines and suicidal behavior. Only articles from peer-reviewed journals were selected for inclusion in the present review. Most studies documented the association between suicidality and IL2, IL-6, IL-8, TNF-α and VEGF levels that have been found altered in suicidal behavior. The presence of major depressive disorder (MDD) with suicidal ideation/attempts was associated with differences in inflammatory cytokine profile when compared to that without suicidal ideation/attempts. Most suicide attempters or subjects with suicidal ideation showed an imbalance of the immune system but this does not imply the existence of a causal link. Also, not all studies demonstrated a positive correlation between inflammatory cytokines and suicidal behavior. Further additional studies should elucidate the molecular mechanisms of the immune activation pathways underlying suicidality.
越来越多的证据表明，炎症介质在重度抑郁症和自杀行为的病理生理学中起着关键作用。在主要情感障碍和自杀行为中都报道了免疫差异。具体而言，已显示促炎细胞因子水平升高与抑郁的严重程度相关，并且已经鉴定出各种细胞因子在理解主要情感障碍/自杀的病理生理学方面可能很重要。我们旨在对当前文献进行系统综述，以调查炎症细胞因子与自杀行为之间的关联。本综述仅纳入了经过同行评审的期刊上的文章。大多数研究记录了自杀行为与 IL2、IL-6、IL-8、TNF-α 和 VEGF 水平之间的关联，这些水平在自杀行为中发生了改变。与没有自杀意念/尝试的患者相比，有自杀意念/尝试的重度抑郁症（MDD）患者的炎症细胞因子谱存在差异。大多数自杀未遂者或有自杀意念的受试者表现出免疫系统失衡，但这并不意味着存在因果关系。此外，并非所有研究都表明炎症细胞因子与自杀行为之间存在正相关。还需要进一步的额外研究来阐明导致自杀的免疫激活途径的分子机制。
